Severe tooth pain worsened or triggered by heat cold

Severe tooth pain worsened or triggered by heat, cold, chewing
 Mouth traua with bleeding, swelling, or soreness
 Sjogren’s syndrome
 Salivary gland stones
6. List appropriate counseling and preventative strategies when self-treating patients with canker
sores, minor oral mucosal injury and irritation, tooth hypersensitivity, cold sores, and xerostomia.
 Canker sores
 Minor oral mucosal injury and irritation
 Tooth hypersensitivity
 Cold sores
 Xerostomia
7. Identify appropriate patient self-monitoring and follow-up for canker sores, minor oral mucosal
injury and irritation, tooth hypersensitivity, cold sores, and xerostomia and when a patient referral
to a dentist or another health care provider should occur.
 Canker sores
o Contact MD:
 Symptoms not better after 7 days of treatment with oral debriding/wound
cleaning agent
 Lesion not healing in 14 days
 Symptoms worsen with self-treatment
 Symptoms of systemic infection – fever, rash, or swelling
 Minor oral mucosal injury and irritation
o Follow up with MD/Dentist
 Symptoms after 7 days treatment
 Symptoms worsen with self-care
 Systemic infection symptoms or fever, redness, swelling
o Stop when symptoms resolve
 Usually 7-10 days after initial injury
 Tooth hypersensitivity
 Cold sores
o Follow up with physician

 Lesions do not heal in 14 days
 Self-treatment doesn’t relieve discomfort
 Systemic symptoms – fever, malaise, rash, swollen lymph glands
 Symptoms change or worsen
 Recurrence despite appropriate self-care treatment
 Xerostomia
Heartburn & Dyspepsia
1. Recognize risk factors that can exacerbate heartburn and/or dyspepsia
 Certain foods & beverages
o Spicy foods, chocolate, coffee, carbonated or caffeinated beverages, fatty foods,
peppermint, alcohol, etc.
 Lifestyle
o Overeating
o Eating < 2 hours before bedtime
o Stress
 Medications
o Aspirin/NSAIDs, theophylline, bisphosphonates, anticholinergic agents, nitrates,
chemotherapy, estrogen/progesterone
 Pregnancy
 Genetics
 Certain disease states
o Gastroparesis
o Scleroderma
o PUD
o Zollinger-Ellison disease
o All of these arem ore likely to cause long-term symptoms than short-term
2. Identify patients that are candidates for self care of heartburn and/or dyspepsia and patients requiring
referral to a healthcare provider
 Exclusion criteria:
o Frequent heartburn > 3 burns
o Severe heartburn
o Nocturnal heartburn
o Vomiting blood or coffee ground appearance
 Symptoms of GI bleed; also may have dark colored stool
o Chronic hoarseness, wheezing, coughing, or choking
 Acid getting all the way up into the throat
 Could also have difficulty swallowing or feel like they have something in their
throat

o Unexpected weight loss
 May be indicative of some type of cancer
o Continuous N/V/D
o Chest pain with sweating, shortness of breath, pain radiating to shoulder, arm, neck, or
jaw
 Can be indicative of heart attack
o Difficulty or pain swallowing solid food
o